Tag Archives: health

I Missed a Febrile Seizure

Twice in the last 5 years I have held a child who was having a febrile seizure.  The first time I recognized it almost immediately but the second time, just a couple days ago, I didn’t realize that a seizure had happened until 2 days later.

If you’ve never heard of them, febrile seizures are sort of like electrical storms in the brain.  They typically occur in 2% to 5% of children between the ages of 6 months to 5 years[1] and the seizure generally happens at the onset of a high fever (102⁰F taken rectally).

A febrile seizure is not caused by epilepsy.

Some statistics worth sharing:

  • Febrile seizures tend to run in families
  • Children under 12 months of age at the time of their first seizure have a 50% chance of having another febrile seizure
  • Children who experience their first febrile seizure after 12 months have a 30% chance of having another febrile seizure

Would you know how to recognize a febrile seizure?

While teaching in public schools I overheard a conversation that a new special education teacher was having with her experienced assistant.  The assistant mentioned that many parents and teachers fail to recognize small seizures in their children because the signs can be hard to spot and don’t last long.  She mentioned that sometimes it’s as simple as a far off stare with the arms raising slightly seemingly of their own will. 

At the time, the only type of seizure I had heard about was grand-mal seizures: the kind typically represented in mainstream media with a person falling to the floor and convulsing. I hadn’t realized that the signs of a seizure could be so subtle as a bizarre stare and arm-raising.

About 5 months after overhearing the conversation, I had the opportunity to witness a febrile seizure first hand in my daughter.  She was 16 months old and had just developed a high fever in a very rapid period of time.  In the matter of half an hour her temperature went from normal to over 103⁰F taken orally.

My daughter and I were visiting family out-of-state and we didn’t have health insurance.  While discussing the financial pitfall a trip to the doctor would create for us due to our lack of insurance, her eyes rolled back in an unusual way, followed by a blank stare and some abnormal drooling.  Her body had stiffened during the event and she completely slumped over when it ended.  The whole thing probably lasted only 10-15 seconds, but it was enough for me to know that something had happened that wasn’t normal.

My brain went into “research memory mode” and stumbled upon the information about seizures from the conversation and I determined that health insurance or not—my daughter needed to see a doctor.  At that point, I still had no knowledge of febrile seizures but was fairly certain my daughter had had a seizure.

The doctor we saw confirmed that my toddler had massive ear infections as well as her sinuses and upper respiratory tract being infected.  He then went on to tell me that she’d had a febrile seizure and talked to me about them.  He mentioned that they tend to run in families, but to my knowledge, nobody in my family had ever had a seizure.

The next morning when I called my mother-in-law to share our experience, she told me that all 4 of her children had, at one point in their youth, experienced a febrile seizure.  This would have been very useful information BEFORE it happened!

A healthy dose of antibiotics and some fever reducers helped get my daughter back to her cheery self in a day or two.

Sadly, my second experience with a febrile seizure happened without me knowing it at all.

Monday afternoon one of the little boys I babysit (age 25 months) began to act really run down.  I held him to give him a hug and realized he felt a little warm.  As his level of tolerance decreased and his crabbiness increased, I picked him up and held him close in my rocking chair.  His mother was due to arrive at any minute and he clearly needed some loves.

While holding him, his eyes closed and I thought he was on the verge of sleep. 

You know how sometimes as you fall asleep you sort of jerk yourself awake?  Or have you ever held a child who did that?

Well, that’s that this little boy did, except the jerky motion was magnified and it happened 3 times in quick succession.  I would have to say the first two convulsions happened about 8 seconds apart and the last one, which was milder, was about 15 seconds later.  These were definitely stronger than the typical “falling asleep shake”.

I was holding him at an angle so the side of his head was resting on my chest.  His eyes definitely had a far-off stare, but I attributed that to his “falling asleep”.  I suspect that if I’d been looking at him straight on that I would have seen an eye-roll similar to what my daughter had done.

When his mother arrived he immediately put his head on her shoulder and didn’t move.  I took the time to explain what had happened.  A fever-virus-cough had made the rounds through my home so I thought perhaps he’d caught that.

When his fever didn’t go down and his mother realized he was one sick little boy, she took him into the emergency room.  She gave the ER doctor a description of the jerking I’d mentioned and the doctor said that he’d had a febrile seizure.  Like me, she didn’t know much about them and was given the same information I had been given several years ago about treatment (there is none), their harmless effect, and cause.

In this little boy’s case, an ear infection was to blame.  He has tubes in his ears so his mom was surprised to find out there was an infection.  In fact, further testing revealed that his infection is in the mastoid bone as well, so it had spread quite rapidly beyond the typical ear infection.

In a nutshell, if you have a child who develops a high fever, particularly if the fever goes up rapidly, watch for any one or combination of the following:

  • Far-off stare or “eyes rolling back in the head”
  • Abnormal and/or excessive drooling
  • Jerking/convulsive movement, particularly on one side of the body or with just one limb
  • Loss of consciousness

If you suspect your child has had a febrile seizure, the American Academy of Pediatrics says to call your doctor right away.  Although there is no treatment for febrile seizures, the doctor will want to examine your child to find out why the fever is there in the first place.

For more information on febrile seizures, click here.

If you’d like more information on infections of the mastoid (mastoiditis), read here.


[1] American Academy of Pediatrics www.healthychildren.org

 

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